Abstract
Quoting a 42 year old female patient, transparotid extirpation of a parapharyngeal tumor was described. She was introduced to our department because of left inf raauricular swelling noticed two weeks previously. From the findings of preoperative examinations including CT, MRI, carotid angiography and Matas' test, the tumor was diagnosed as being situated both in the pre- and poststyloid portions of the parapharyngeal space, pushing the internal carotid artery medially, being fed by vasa vasorum of the internal carotid artery. The collateral pathway to the brain was kept in good condition.The surgical procedures were as follows. A skin incision was made from the preauricular to the submandibular regions. After detaching the parotid cupsule from the anterior border of the sternocleidomastoid muscle, the surface of the tumor was identified under the digastiric muscle. The trunk of the facial nerve was identified and the inferior ramus was torn to the posterior facial vein. The hypoglossus nerve was preserved but the vagus nerve was cut because of tight adhesion to the tumor. With many ligations of the feeding vessels, the tumor was successfully extirpated. It was histologically a neurinoma. A postoperative course was uneventful except for slight hoarseness and aspiration, which were compensated within a few weeks. A most adequate surgical technique should be chosen from the findings of preoperative examinations as to localization, size, vascularity and pathology.
